Inflammation plays a major role in the pathophysiology of
asthma. Therefore, monitoring of the disease and its management preferably should include assessment of mediators of airways
inflammation. Much interest has been focused on using
eosinophil granule proteins in blood and urine as markers of
asthma inflammation. The
eosinophil granule proteins are important mediators in allergic
inflammation. They often function well as inflammatory markers when used in controlled clinical studies, and are therefore useful research tools. With urinary eosinophil-derived
protein X (EPX) venous blood sampling is avoided. Disadvantages which limit usefulness in clinical practice are overlap between values in patients and controls, a rather weak correlation to traditional lung function variables, elevation of levels by concurrent allergic disease, and the delay between sampling and test results. Urinary excretion of
leukotriene E4 (LTE(4)) reflects the production of cysteinyl
leukotrienes, which are major mediators in
asthma. The excretion of
LTE4 possibly reflects lung function better than serum ECP. In the future, monitoring of
cytokines may be used in clinical
asthma to monitor control and aid in the prognosis of the disease in the young child. Techniques for simple and rapid monitoring of key type 1 and type 2
cytokines are needed.